Thibaud Eckenschwiller, VP & Managing Director for Ipsen Italy, shares his impression of the Italian pharmaceutical market after one year in office, how he is applying Ipsen’s global strategy to one of the group’s core markets and how he plans to maintain the affiliate’s position as a leader of specialized care in Italy.
Having taken up the office of Managing Director in Italy just over a year ago after your time managing Ipsen in Spain, what has been your impression of the Italian pharmaceutical market so far?
It is certainly an interesting market, largely due to the regionalization of the country. There is a paradox here, because Italy is a market where decisions such as budget and market authorization are taken at a central level, however it is also a market where after that certain decisions are taken at a regional level. For example, the national healthcare system, the SSN, is becoming more regionalized rather than centralized. As a consequence, it is inevitable, and to a certain extent this is already visible today, that you have differing levels of care available to you depending on where in the country you live. Clearly this is contrary to what a national healthcare system should be about. Also in terms of funding, the central state is providing the regions with their budgets, but the regions decide to a large extent how that is allocated, and that introduces an uncertainty to the market. This uncertainty as to who makes decisions also makes it more difficult, as a company, to act for the long term. In that sense it is similar to Spain, with increased regionalization making it difficult to gain visibility on the potential of investments, which stability would afford.
Ipsen’s global strategy is centered around a three-pronged approach targeting the company’s traditional therapeutic lines, growth in large markets such as the US and China, and developing its primary care segment. How does Ipsen Italy fit into this picture?
It fits very well in the specialty care market, with all of our products in those lines represented here. We are number one or number two in the Italian market in all of the therapeutic areas in which we are selling our products, which gives us a very strong position from which to continue to grow in that area. In terms of primary care, we are considering acquisitions in the primary care segment in the country. This demonstrates just how much we believe in Italy. As I said making investments here is not always straight-forward, so the fact that we are pushing ahead in such a strong way clearly shows the potential we see for the country in this regard. In all I would say we are well positioned as an affiliate within the group, being the fifth-largest affiliate over-all, and third in terms of the specialty care segment. Clearly in terms of growth potential we cannot compete with markets such as China, Brazil or the US, which is a new market for us, however we do retain a strong foothold within the group.
Italy is renowned for the excellence of its physicians and researchers, and another contribution Ipsen Italy makes to the group is as part of the iXcellence program. Can you tell us what the country’s unique strengths are which led it to be chosen as one of the first to host the program?
Italy is certainly a country with an excellent reputation for its scientific and medical research. This is no surprise, as when you talk to physicians here they are truly in the top-level globally. Clearly the qualities of the physicians we enrol in the program need to be top-level. They are key opinion leaders who can train and tell the medical community how the drugs work, and how the treatment paradigm should work. To involve Italian physicians is a necessity, not just for us as an affiliate but also for the program itself, as they give a lot back to us and contribute greatly to its overall value. So it is a mutual exchange in this regard, and it requires a strong program to attract them.
To continue on the excellence of researchers in Italy, they are certainly a draw for the country. However, the attractiveness of Italy as a whole could be challenged by its bureaucracy. A clear example of this is the number of ethical committees from which approval is needed before clinical trails can be performed. We are competing with countries where the approval process is much more streamlined, and this is a disadvantage for Italy. I am not debating the necessity of ethical committees, but in Germany I get approval or refusal for a trial in three months, whereas in Italy it can take up to a year. On top of that the number of committees introduces more uncertainty, as it is possible to receive approval from one committee and then refusal from others. So when we have centers in Italy which we want to enrol in a clinical trial we are competing with other countries, and one large factor in the attractiveness of a country lies in the speed of decisions. We can compensate to an extent with the excellence of our scientists and of those centers, but that is not always enough.
Another way in which Italy’s strong scientific background is a benefit to companies is through collaborations with Italian universities. How is Ipsen taking advantage of this?
Usually we collaborate to develop phase two and three program through university hospitals. These collaborations are scattered throughout the country in both the North and the South, as there is certainly excellence spread across the country. Naples for example is a world-renowned center for Acromegaly or Neuroendocrine tumors. We have agreements with those centers which are closely linked to the physicians themselves, as they have the knowledge and the specialty we need. This is because they are working in very specialized areas, for Acromegaly for example there are around five thousand patients in Italy, so when you do research on this you need to go to the specialists who know the patients. In Rome we also have a long-standing research agreement with the Tor Vergata university.
After a year in office, what are your strategic objectives for Ipsen in Italy, and how do you plan on maintaining the affiliate’s position as a leader of specialized care in the group?
First of all, through hard work. I think the core of this strategy is, and this is not meant as a marketing slogan, entirely centered around the patient. I know this is something a lot of pharmaceutical companies say, that they speak a lot about putting the patient first, and being patient-centric. Ipsen though started, not to talk about the patients, but to really work with them years ago. At the end of this month we are celebrating our 25th anniversary in Italy, and we have named the event ’25 years close to the patient’, because our story began there, and not with the physician.
So for the strategy, if you can provide something which meets, again not the physician’s, but the patient’s needs, then you are well-off for the future. At the end of the day, the pharmaceutical industry is one of the few in which the person choosing the product is not the same as the one who uses it. The physician chooses the product, and the patient uses it, and the taxpayer pays for it. Unlike most industries where these are the same person. So it is not about who chooses or buys the product, but about to uses it. That means that you need to offer a product which changes the patient’s life, for example in our case, with Acromegaly our medicines truly change the way patients live their lives. We anticipate a new indication for a neuroendocrine tumor product which has an anti-tumoral impact, and so again it is changing their life, in this case if not necessarily by saving their life but certainly by extending it, which is very valuable. I think that is the secret of Ipsen, to be able to give patients drugs which are changing their lives. I must emphasize that these are not empty words, we really live and breathe this.
What is your vision for Ipsen Italy for the next three years?
We are number one or two in the areas in which we are active, so the vision is to be number one across the board. Not just in terms of sales, but for Neuroendocrine tumors for example, if the physicians are looking at Ipsen as the reference in that field, because we know the pathology, we know the treatment paradigm, and this makes us the most suitable partner for them to treat neuroendocrine tumors, then we will be number one. The same can be said for neurology and movement disorders. So this is our strategy. Growing by a certain percentage is a consequence of this, but the central aim should be to provide highly effective drugs which strike at the core of the disease and thereby change patients lives, like this we can become the reference in those fields and if we can do that then the rest will follow.
